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Background The nursing shortage is of worldwide concern, with nursing student retention acknowledged as a priority. As a fundamental step towards exploring factors that can guide the implementation of strategic approaches to retain undergraduate nursing students and prevent their attrition, the aim of this study is to examine the motivation for choosing nursing studies of first-year nursing students within the theoretical framework of self-determination theory. Methods We conducted a study at the Medical School of the University of Palermo. A total of 133 first-year nursing students completed a two-part questionnaire: a measure of socio-demographic aspects and an open question about their motivation for choosing nursing studies. Students’ responses were analysed using thematic analysis. Dimensional analysis was performed in order to verify an organization along one dimension, in agreement with the differentiation of the autonomous and controlled types of motivation of self-determination theory. A person-centred approach was utilised to define motivational profiles able to characterize clusters of students according to both quality and quantity of motivation. Results A set of 18 categories was developed. The factor analysis has shown that nursing students’ motivations can be organized along one dimension, in alignment with the differentiation of the autonomous and controlled forms of motivation of self-determination theory. Through adoption of a person-centred approach, four motivational profiles were identified: a) students with good quality motivation profile (high autonomous and low controlled); b) students with poor quality motivation profile (low autonomous and high controlled); c) students with low quantity motivation profile (low autonomous and low controlled); d) students with low quantity and poor quality motivation profile (i.e. prevalence of controlled motivation). Conclusions Importance of this research includes the possibility to interpret nursing students’ reasons within the theoretical framework of self-determination theory, a well-grounded model able to offer useful information to academic nursing schools, in order to promote effective strategies to foster and support student motivation.

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Background: Quality of life (QoL) is an important outcome in the management of children with asthma. Mobile Health (m-Health) and Therapeutic Education Programs (TEPs) are increasingly recognized as essential components of pediatric asthma management to improve disease outcomes. Objective: To evaluate the effect of an education program (MyTherapeutic Education Program, MyTEP) that couples multidisciplinary TEP intervention with an m-Health Program (mHP) in improving QoL in asthmatic children.Methods: This single-center study employed a nonblinded randomized clinical trial design. Italian-speaking children (6-11 years) with mild-moderate asthma were eligible for participation. Participants were randomly paired 1:1 with a control group that received mHP (smartphone app) or an intervention group that received MyTEP (TEP plus a smartphone app). Patients were followed up for 3 months. Descriptive statistics, Least Square (LS) mean change and Generalized Linear Mixed model were used for analysis. Results: Fifty patients were enrolled. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) score improved in both MyTEP (p = 0.014) and mHP (p = 0.046) with the minimally clinically significant difference of ⩾0.5 points reached in 23% of MyTEP and in 16% of mHP. Changes in PAQLQ scores were significantly greater in MyTEP than in mHP (LS mean difference: 0.269 p = 0.05). PAQLQ score was: positively associated with MyTEP (p = 0.023) and study time (p = 0.002); and inversely associated with current passive smoke exposure (p = 0.003). Conclusion: Despite the small sample size and short observation period, this study demonstrated that implementing a multidisciplinary TEP with an m-Health program results in gains in QoL of children with asthma.